Barnwell Jessica, Deol Paramjeet Singh
Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
Chelsea and Westminster Hospital, London, UK.
BMJ Case Rep. 2017 Jan 24;2017:bcr2016218405. doi: 10.1136/bcr-2016-218405.
We present a case report of atraumatic splenic rupture secondary to Epstein-Barr virus (EBV) infection. A woman aged 36 years presented to a London teaching hospital's Accident and Emergency department with severe abdominal pain following a 6-day history of diarrhoea and vomiting, which had been under review by her GP. A CT scan demonstrated free intraperitoneal fluid and abnormal appearance of her spleen. Blood tests demonstrated EBV infection with positive serology and leucocytosis. She underwent a laparoscopic washout, which confirmed a subcapsular splenic haematoma that was initially managed conservatively. However, she subsequently re-presented with increasing pain and required an elective splenectomy. This case demonstrates the risk of splenic rupture following EBV infection, even in the absence of trauma, and highlights the importance of prompt diagnosis and appropriate counselling in patients with infectious mononucleosis.
我们报告一例因爱泼斯坦-巴尔病毒（EBV）感染继发的非创伤性脾破裂病例。一名36岁女性因腹泻和呕吐6天后出现严重腹痛，前往伦敦一家教学医院的急诊部就诊，其全科医生一直在对其进行检查。CT扫描显示腹腔内有游离液体，脾脏外观异常。血液检查显示EBV感染，血清学呈阳性且白细胞增多。她接受了腹腔镜冲洗，证实为脾包膜下血肿，最初采取保守治疗。然而，她随后因疼痛加剧再次就诊，需要择期行脾切除术。该病例表明，即使没有创伤，EBV感染后也存在脾破裂风险，并强调了对传染性单核细胞增多症患者进行及时诊断和适当咨询的重要性。
